基弧区非球面设计与球面设计角膜塑形镜在近视伴中高度散光青少年中的应用效果比较

Comparison of Application Effect of Basic Arc Region Aspheric Design and Spherical Design Orthokeratology Lens in Adolescents with Myopia and Moderate to High Astigmatism

目的:比较基弧区非球面设计与球面设计角膜塑形镜在近视伴中高度散光青少年中的应用效果。方法:选取2019年2月—2022年2月于江苏大学附属武进医院诊治的190例(380眼)近视伴中高度散光青少年患儿作为研究对象。依据随机数表法将患儿均分为对照组(95例190眼)和研究组(95例190眼)。对照组予以基弧区球面设计角膜塑形镜,研究组予以基弧区非球面设计角膜塑形镜。比较两组临床应用效果及佩戴不良反应发生情况。结果:干预前,两组近视度、散光度及裸眼视力(UCVA)比较,差异无统计学意义(P>0.05)。干预后,两组近视度、散光度均优于干预前,且研究组优于对照组,差异有统计学意义(P<0.05);干预后,两组UCVA低于干预前,且研究组低于对照组,差异有统计学意义(P<0.05)。两组干预前后眼表形态及组内睑板腺缺失程度评分比较,差异无统计学意义(P>0.05);干预后,两组仅眼表疾病指数量表(OSDI)评分低于干预前,差异有统计学意义(P<0.05)。两组干预前后泪膜稳定性比较,差异无统计学意义(P>0.05);干预后,两组泪膜破裂时间(BUT)、泪液分泌实验(LST)低于干预前,角膜荧光素染色实验(FL)高于干预前,差异有统计学意义(P<0.05)。两组佩戴不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在青少年近视伴中高度散光的临床矫正治疗中,基弧区非球面设计角膜塑形镜的矫正效果明显优于基弧区球面设计角膜塑形镜;两种塑形镜对患者眼表形态和泪膜稳定性影响无明显差异,且在佩戴过程出现的不良反应无差异。

Objective:To compare the application effect of basic arc region aspheric design and spherical design orthokeratology lens in adolescents with myopia and moderate to high astigmatism.Method:A total of 190 adolescents(380 eyes)with myopia and moderate to high astigmatism who diagnosed and treated in Wujin Hospital Affiliated to Jiangsu University from February 2019 to February 2022 were selected as the research objects,the children were divided into the control group(95 cases,190 eyes)and the study group(95 cases,190 eyes)according to the random number table method.The control group was given basic arc region spherical design orthokeratology lens,while the study group was given basic arc region aspheric design orthokeratology lens.The clinical application effect and the occurrence of adverse reactions during wearing were compared between two groups.Result:Before intervention,there were no statistically significant differences in myopia,astigmatism and uncorrected visual acuity(UCVA)between two groups(P>0.05);after intervention,the myopia and astigmatism of two groups were better than those before intervention,and those in the study group were better than those in the control group,and the differences were statistically significant(P<0.05);after intervention,the UCVA of two groups were lower than those before intervention,and that in the study group was lower than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in ocular surface morphology and meibomian gland loss score between two groups before and after intervention(P>0.05);after intervention,the ocular surface disease index(OSDI)score of two groups were lower than those before intervention,and the differences were statistically significant(P<0.05).There were no significant differences in the stability of tear film between two groups before and after intervention(P>0.05);after intervention,the tear film break-up time(BUT)and tear secretion test(LST)of two groups were lower than those before intervention,and corneal fluorescein staining test(FL)were higher than those before intervention,the differences were statistically significant(P<0.05).There was no statistically significant difference in adverse reactions during wearing between two groups(P>0.05).Conclusion:In the clinical correction of adolescents myopia with moderate to high astigmatism,the correction effect of basic arc region aspheric design orthokeratology lens is significantly better than that of basic arc region spherical design orthokeratology lens;there are no significant differences in the effect of two kinds of orthokeratology lenses on the ocular surface morphology and tear film stability,and there is no difference in the adverse reactions during wearing.